Ewing sarcoma, pediatric

Section editor transclusions Are you looking for a regimen, but can't find it here? It is possible that we've moved it to the historical regimens page. If you still can't find it, please let us know so we can add it!

0 regimens on this page 0 variants on this page

Upfront Therapy

COG AEWS1031

Regimen A Induction

• Regimen A is a standard regimen consisting of 14 day cycles

Chemotherapy, VDC portion

• Vincristine (Oncovin) as follows:
  • Cycles 1, 3, 5: 1.5 mg/m²/dose IV push once on day 1 of weeks 1, 2, 5, 6, 9 & 10 (maximum dose of 2 mg)
    • For children < 10 kg or < 1 year, the dose is 0.05 mg/kg/dose
• Doxorubicin (Adriamycin) as follows:
  • Cycles 1, 3, 5: 37.5 mg/m²/dose IV push/infusion over 1-15 minutes on days 1 and 2 of weeks 1, 5 and 9.
    • For children < 10 kg or < 1 year, the dose is 1.25 mg/kg/dose
    • Administer at a concentration not to exceed 2 mg/mL. Doxorubicin (Adriamycin) should be administered through the tubing of rapidly infusing solution of D5W or 0.9% NaCl, and it should not be infused into a large vein
• Cyclophosphamide (Cytoxan) as follows:
  • Cycles 1, 3, 5: 1200 mg/m²/dose IV over 30 to60 minutes on day 1 of weeks 1, 5 and 9
    • For children < 10 kg or < 1 year, the dose is 40 mg/kg/dose
    • May be administered as undiluted drug (20 mg/mL, reconstitute with 0.9% NaCl to avoid hypotonic solution) or further diluted

Supportive medications, VDC portion

• Mesna (Mesnex) as follows:
  • Cycles 1, 3, 5: 720 mg/m²/day by IV infusion or IV/PO with Cyclophosphamide (Cytoxan) on day 1 of weeks 1, 5 and 9
    • For children < 10 kg or < 1 year, the dose is 24 mg/kg/dose

Chemotherapy, IE portion

• Ifosfamide (Ifex) as follows:
  • Cycles 2, 4, 6: 1800 mg/m²/dose IV infusion over 1 hour on days 1, 2, 3, 4, and 5 of Weeks 3, 7 and 11
    • For children < 10 kg or < 1 year, the dose is 60 mg/kg/dose
    • Achieve urine specific gravity ≤ 1.010 prior to start of Ifosfamide (Ifex).
• Etoposide (Vepesid) as follows:
  • Cycles 2, 4, 6: 100 mg/m²/dose IV infusion over 1 to 2 hours once on days 1, 2, 3, 4, and 5 of weeks 3, 7 and 11
    • For children < 10 kg or < 1 year, the dose is 3.3 mg/kg/dose

Supportive medications, IE portion

• Mesna (Mesnex) as follows:
  • Cycles 2, 4, 6: 1080 mg/m²/day by IV infusion or IV/PO with ifosfamide on days 1, 2, 3, 4, and 5 of Weeks 3, 7 and 11
    • For children < 10 kg or < 1 year, the dose is 36 mg/kg/dose

14-day cycle for 6 cycles